Purpose:
The ability to image the peripheral retina has become increasingly important for the diagnosis and management of infants with proliferative retinopathies. A new generation of “ultra-widefield” imaging devices have become available that permit simultaneous capture of the posterior pole as well as the peripheral retina. These camera systems have been extensively explored in the adult population but their uses in infants have been limited. We evaluated the use of non-contact ultra-widefield fundus fluorescein angiography (NC-UW-FFA) in infants.

Methods:
A retrospective review of all infants who underwent NC-UW-FFA using the Optos Optomap and/or Heidelberg Spectralis ultra-widefield angiography module was performed. The ability to capture images, quality of images, and the field of view obtained were evaluated for each imaging system.

Results:
A total of 22 infants (17 premature, 5 term) with diagnoses of retinopathy of prematurity, familial exudative vitreoretinopathy, and incontinentia pigmenti underwent NC-UW-FFA. 10 infants were imaged with the Optos Optomap, 12 infants with the Heidelberg Spectralis, and 5 infants with both the Optos Optomap and Heidelberg Spectralis. NC-UW-FFA was successfully performed in all infants that used the Optos Optomap and/or Heidelberg Spectralis. Both imaging modalities provided high quality angiograms with views of the periphery, but areas of retinal ischaemia and neovascularization were better revealed with the Optos Optomap. The Optos Optomap was able to image a wider field of view temporally and nasally in comparison to the Heidelberg Spectralis, while the Heidelberg Spectralis was able to capture a wider field of view superiorly and inferiorly.

Conclusions:
NC-UWF-FFA with the Optos Optomap and/or Heidelberg Spectralis was successfully performed in infants. The ability to image the posterior pole and peripheral retina simultaneously was important for documentation, diagnosis, and management.